Nevin Manimala

Child Dev. 2026 Apr 13:aacag031. doi: 10.1093/chidev/aacag031. Online ahead of print.

ABSTRACT

Compared to other developmental processes, such as cognitive control, there is relatively little consensus on the developmental trajectory of statistical learning (the ability to implicitly extract environmental regularities). The literature is further complicated as statistical learning may comprise distinct subtypes, differing in the regularities being tracked. Three statistical learning abilities and cognitive control were assessed in one hundred eighty-seven 5-12-year-olds (42.8% female, 84.6% White) at a university laboratory between March 2023 and August 2024. The ability to extract cue-based and nonadjacent statistics was age invariant, whereas adjacent dependency extraction yielded a greater benefit in younger than in older children. Despite research suggesting immature top-down guidance facilitates statistical learning, there was only weak evidence of an association with cognitive control, and the direction of these associations varied between “online” and “offline” measures of children’s sensitivity to adjacent dependencies. Importantly, the different subtypes were uncorrelated, supporting the notion that statistical learning is multifaceted.

PMID:41973827 | DOI:10.1093/chidev/aacag031

JMIR Serious Games. 2026 Apr 13;14:e80684. doi: 10.2196/80684.

ABSTRACT

Chronic health conditions impose substantial financial and operational burdens on the public health sector and insurance providers in the United Kingdom. While gamification demonstrates the potential for enhancing health behavior, a structured analysis linking to established behavioral frameworks is missing. We provide a viewpoint on whether, as health and life insurers transition from traditional risk assessment toward proactive risk reduction strategies, gamification offers an innovative mechanism to strengthen their prevention initiatives and insurer-insured relationships. We examine how gamification aligns with key theoretical models, including the Behavior Change Wheel and Behavior Change Techniques, and how gamification elements can be mapped onto them. This enables combining multiple Behavior Change Techniques into effective interventions, which provide engaging user experiences and promote intrinsic motivation. We distinguish gamification from mere incentivization, highlighting its potential for sustained health outcomes. We also explore the ethical and practical considerations of gamification in the insurance sector. We highlight the need for a robust ethical framework that preserves an individual’s ability to make free and informed decisions, while ensuring inclusivity and absence of discrimination based on personal characteristics that may affect their capacity to engage in healthy behaviors. Similarly, we highlight how privacy, transparency, and accountability need to be prioritized in the governance structure of gamification programs in the sector. Our analysis emphasizes that gamification has the potential to represent the new panacea for the insurance sector, if effective gamified interventions incorporate inclusive design principles, theoretical grounding, ethical accountability, and continuous refinement to ensure alignment with long-term public and individual health objectives. This viewpoint is the first to map gamification and behavioral change frameworks into a unified model for insurer-led health behavior interventions and encourage greater investment in gamified wellness products and the use of theory-driven behavioral science in insurance-led digital health tools.

PMID:41973825 | DOI:10.2196/80684

J Fam Psychol. 2026 Apr 13. doi: 10.1037/fam0001467. Online ahead of print.

ABSTRACT

Statistical adjustments (i.e., partialing) for between-partner correlations on the same variable and for correlations among multiple predictors within individuals are common in relationship research. Although useful, partialing can alter the construct validity or meaning of measured variables in ways that are typically not considered. In this study of 300 middle-aged and older couples, unadjusted, partner-partialed, partialed warmth and hostility component, and common fate model scores for observer-rated behavior during marital conflict discussions were compared using interpersonal circumplex-based spouse ratings of targets’ behavior during those discussions, as well as self-reports of marital quality (i.e., overall marital adjustment, support from spouse, conflict). Unadjusted scores for observer-rated affiliation-and its two components, warmth, and hostility-had expected associations with interpersonal circumplex-based spouse ratings and self-reports of marital quality. Compared to unadjusted scores, partner-partialing, analogous to the actor-partner interdependence model, resulted in significantly weaker associations of behavioral scores with the expected interpersonal content of spouse ratings, and weaker associations with reported marital quality. Partialing of warmth and hostility within individuals also resulted in weaker associations with spouse ratings and marital quality, and some shifts in the theme of spouse ratings. In contrast, common fate model scores had expected associations with these criteria that equaled or exceeded the magnitude for unadjusted scores. Thus, common forms of partialing in relationship research can weaken the construct validity of behavioral observation variables, and common fate model scores represent a viable alternative in some instances. Implications for the design, reporting, and evaluation of couple research are discussed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:41973814 | DOI:10.1037/fam0001467

Dev Psychol. 2026 Apr 13. doi: 10.1037/dev0002185. Online ahead of print.

ABSTRACT

The present study reports the natural statistics of everyday motor experiences, measured throughout the day using wearable inertial sensors. Using a large data set of infants’ real-time upright, sitting, prone, supine, and held experiences, we investigated how age and motor skill relate to the frequency and bout structure of body position. Our analyses replicated past survey and observational work by showing that older infants (11-14 months) spend more time sitting and upright compared with younger infants (4-7 months) and that the emergence of sitting and walking skills may contribute to these age differences. Furthermore, our analyses were novel in revealing that a larger share of younger infants’ bouts were longer-lasting several minutes and even over an hour. In contrast, older infants had a greater share of shorter bouts less than 1 min long, suggesting they experience a greater mix of positions. Within older infants, bout duration distributions also varied according to walking skill. We discuss the importance of understanding the natural statistics of motor experiences at different timescales for characterizing infants’ opportunities for motor learning and perceptual-motor exploration in daily life. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PMID:41973804 | DOI:10.1037/dev0002185

J Health Organ Manag. 2026 Apr 14:1-15. doi: 10.1108/JHOM-12-2025-0889. Online ahead of print.

ABSTRACT

PURPOSE: The increasing use of artificial intelligence (AI) and large language models such as ChatGPT in healthcare has highlighted the need to understand physicians’ perceptions and readiness for clinical adoption.

DESIGN/METHODOLOGY/APPROACH: This cross-sectional study included 328 physicians. Data were collected through face-to-face surveys incorporating sociodemographic items, AI/ChatGPT knowledge and interaction questions, and two validated instruments (MAIRS and TAME-ChatGPT). Descriptive statistics, correlations, and simple linear regression were used to identify predictors of ChatGPT acceptance.

FINDINGS: Physicians demonstrated moderate awareness of AI, while nearly half lacked knowledge about ChatGPT. Among AI readiness dimensions, MAIRS-Ability was the strongest positive predictor of ChatGPT acceptance (β = 0.315, p < 0.001). Vision (β = 0.180, p = 0.001) and Ethics (β = 0.143, p = 0.010) also showed significant positive effects, whereas Cognition was not significant. Among sociodemographic variables, duration of medical practice (β = -0.295, p < 0.001) and marital status (β = -0.117, p = 0.035) negatively predicted ChatGPT acceptance. Knowledge about AI use in healthcare demonstrated the strongest positive association overall (β = 0.396, p < 0.001).

ORIGINALITY/VALUE: Physicians exhibit cautious but growing interest in ChatGPT. AI competence, ethical sensitivity, and demographic factors significantly shape acceptance. Structured AI training and clear ethical guidelines are essential to support safe and effective integration of generative AI tools into clinical practice.

PMID:41973799 | DOI:10.1108/JHOM-12-2025-0889

JMIR Form Res. 2026 Apr 13;10:e77994. doi: 10.2196/77994.

ABSTRACT

BACKGROUND: Over 2.1 million adolescent and young adult cancer survivors (AYACS) live in the United States. Recent estimates suggest that up to one-third of AYACS experience major depressive disorder. Although several efficacious evidence-based interventions are available to manage symptoms of depression, these interventions are often inaccessible to AYACS who have many competing commitments. Digital mental health tools hold promise for this population; however, only a few have been tailored to meet the unique needs of AYACS, and findings to date have yielded mixed results.

OBJECTIVE: This study aims to obtain feedback from AYACS on a mid-fidelity prototype of a depression self-management tool being tailored for AYACS.

METHODS: Individuals with a history of cancer diagnosed at age 12 or older who were between the ages of 15 and 39 and had completed primary treatment were identified through a review of medical records from a comprehensive cancer center in the Southeastern United States. Potentially eligible participants were contacted by study staff to conduct additional screening and obtain informed consent via REDCap (Research Electronic Data Capture; Vanderbilt University). Upon enrollment, participants provided demographic and clinical information, as well as their availability for an interview. The principal investigator (KMI) conducted semistructured individual interviews with consented AYACS. Most of the interview was dedicated to showing participants the mid-fidelity prototype of the tool, explaining how the prototype might work, and requesting targeted feedback. Demographic and clinical characteristics, as well as some aspects of feedback on the prototype, were summarized using descriptive statistics. Interviews were audio- and video-recorded and transcribed. The transcriptions underwent rapid qualitative analysis guided by the Rigorous and Accelerated Data Reduction technique.

RESULTS: A total of 14 AYACS (n=9, 64%, female; n=9, 64%, white; ages 15-38) completed an individual interview. Participant preferences for mood tracking, content presentation, user input, and duration of use were captured qualitatively but analyzed quantitatively. For example, most participants (n=10, 71%) indicated that they preferred a mood-tracking option that included emojis and would be willing to track their mood at least once per day (n=11, 79%). Participant preferences captured qualitatively fell into 4 themes: (1) features to promote user engagement (eg, the use of gamification); (2) tailored content presentation (eg, authenticity in the portrayal of the cancer experience); (3) perceived usability (eg, simplifying user input); and (4) interface design (eg, implementing a coherent design theme and color scheme).

CONCLUSIONS: Findings indicated that AYACS highly value personalization, flexibility, and peer support in digital interventions. Based on insights obtained during individual interviews, a working prototype was developed by reprogramming an existing digital tool. Qualitative and quantitative findings informed modifications to the existing digital tool. The working prototype will next undergo evaluation as part of a pilot full-factorial trial.

PMID:41973497 | DOI:10.2196/77994

Ulus Travma Acil Cerrahi Derg. 2026 Apr;32(4):448-454. doi: 10.14744/tjtes.2026.88572.

ABSTRACT

BACKGROUND: Nasogastric (NG) tube decompression has traditionally been used after abdominal surgery to prevent postoperative ileus and gastric distension. The aim of this study was to evaluate the necessity of NG tube decompression following emergency repair of perforated peptic ulcer (PUP).

METHODS: This retrospective study included 189 patients who underwent emergency surgery for PUP between 1999 and 2017. Patients were divided into two groups: those managed with an NG tube (Group 1, n=154) and those managed without an NG tube (Group 2, n=35). Demographic data, clinical characteristics (American Society of Anesthesiologists [ASA] scores and comorbidities), intraoperative findings, and postoperative outcomes, including length of hospital stay, time to oral intake, and complications, were analyzed.

RESULTS: The study cohort included 189 patients, of whom 84.1% were male, with a mean age of 54.1±19.9 years. Baseline demographic and clinical characteristics, including age, comorbidities, ASA scores, and operative details, were comparable between the two groups. There were no statistically significant differences in postoperative complications or 30-day mortality. However, patients in Group 2 demonstrated a significantly earlier transition to oral feeding (3.7±0.9 vs. 4.3±1.4 days; p=0.03) and a shorter duration of hospital stay (6.6±3.1 vs. 8.1±3.8 days; p=0.04) compared to Group 1.

CONCLUSION: Routine NG decompression is not necessary following surgery for PUP. Avoiding routine NG tube use does not increase morbidity or mortality and is associated with earlier oral intake and a shorter hospital stay. We recommend the use of NG decompression in selected patients when clinically indicated.

PMID:41973493 | DOI:10.14744/tjtes.2026.88572

Ulus Travma Acil Cerrahi Derg. 2026 Apr;32(4):473-479. doi: 10.14744/tjtes.2025.08783.

ABSTRACT

BACKGROUND: The long-term outcomes of arthroscopic tenodesis using the onlay (groove) and inlay (groove) techniques remain debated with respect to tendon healing and graft stability. The aim of our study was to identify the optimal tenodesis strategy by comparing the effects of arthroscopic inlay and onlay techniques on postoperative complication rates, patient satisfaction, and functional recovery.

METHODS: Between 2015 and 2021, the treatment outcomes of 54 patients who underwent arthroscopic biceps tenodesis using either the inlay or onlay technique for the management of superior labrum anterior-to-posterior (SLAP) lesions or biceps tendon de-generation were retrospectively evaluated. Patient demographics and clinical variables, including age, sex, side of involvement, follow-up duration, visual analog scale (VAS) score, Constant score, postoperative cramping, and complications, were recorded. Group 1 consisted of 28 patients who underwent inlay tenodesis, while Group 2 included 26 patients who underwent onlay tenodesis.

RESULTS: Postoperatively, VAS scores improved substantially in both groups, with no significant difference between Group 1 (0.21±0.45) and Group 2 (0.18±0.37) (p=0.789). Similarly, postoperative Constant scores were high in both groups, with Group 1 at 92.73±8.23 and Group 2 at 95.47±5.12; this difference was not statistically significant (p=0.145). The mean recovery time was significantly shorter in Group 2 compared to Group 1. Specifically, the mean recovery time was 12.3±4.8 weeks in Group 1 and 8.3±3.72 weeks in Group 2 (p=0.01). Cramping was reported in 21.42% of patients in Group 1 and 7.69% in Group 2; however, this difference was not statistically significant (p=0.253). In Group 1, Popeye deformity developed in two patients (7.1%), whereas in Group 2 it de-veloped in one patient (3.8%).

CONCLUSION: The present study demonstrates that both inlay and onlay arthroscopic biceps tenodesis techniques are effective surgical options for managing biceps tendon degeneration and superior labrum anterior-to-posterior lesions. However, the findings suggest a potential advantage of the onlay technique, as it is associated with faster recovery and a lower risk of complications.

PMID:41973483 | DOI:10.14744/tjtes.2025.08783

Ulus Travma Acil Cerrahi Derg. 2026 Apr;32(4):480-486. doi: 10.14744/tjtes.2025.03788.

ABSTRACT

BACKGROUND: This study aimed to compare the clinical, radiological, and cost-related outcomes of early spica casting performed without anesthesia in the emergency department and spica casting performed under general anesthesia in the operating room for the treatment of femoral shaft fractures in children under five years of age.

METHODS: One hundred eleven patients who underwent closed reduction and spica casting for femoral shaft fractures between 2020 and 2024 were retrospectively reviewed. Patients were divided into two groups according to where the spica cast was applied: Emergency Department Group (ED group, n=71) and Operating Room Group (OR group, n=40). The groups were compared in terms of age, sex, fracture type, radiological alignment, and treatment costs.

RESULTS: No statistically significant differences were found between the two groups regarding age, sex, fracture pattern, or final radiological alignment. However, treatment costs were significantly lower in the emergency department group. Complication rates were also similar between the groups.

CONCLUSION: Early spica casting performed in the emergency department without general anesthesia provides radiological out-comes comparable to those achieved in the operating room while offering a significant cost advantage. With appropriate patient selec-tion, this method represents a safe and effective treatment option.

PMID:41973481 | DOI:10.14744/tjtes.2025.03788

JAMA Netw Open. 2026 Apr 1;9(4):e263171. doi: 10.1001/jamanetworkopen.2026.3171.

ABSTRACT

IMPORTANCE: Estimates of the impact of lung cancer screening (LCS) largely rely on the 3.97% lung cancer diagnosis rate (LCDR) from the National Lung Screening Trial.

OBJECTIVE: To estimate the LCDR in clinical LCS and incidental pulmonary nodule (IPN) programs.

DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study of a large regional community health care system in the Mississippi Delta included patients who had at least 1 low-dose computed tomography (CT) scan for lung cancer or any CT scan finding an IPN diameter of 30 mm or less and no prior history of lung cancer between January 1, 2015, and June 30, 2024.

EXPOSURE: Patient surveillance in LCS or IPN programs.

MAIN OUTCOMES AND MEASURES: The primary outcome was aggregate LCDRs. Secondary outcomes were relative LCDRs stratified by baseline Lung CT Screening Reporting and Data System (Lung-RADS) score (LCS cohort) or nodule size (IPN cohort). Adjusted hazard ratios (AHRs) were estimated using a Cox proportional hazards model adjusted for age, sex, race, insurance, rurality, comorbidities, personal history of non-lung cancer, and family history of lung cancer.

RESULTS: Among 40 612 patients, 15 754 were enrolled in the LCS cohort (median [IQR] age, 65 [59-69] years; 7990 male [50.7%]) and 24 858 were enrolled in the IPN cohort (median [IQR] age, 64 [52-74] years; 13 919 female [56.0%]). Among patients in the LCS cohort, 13 517 (85.8%), 994 (6.3%), 559 (3.5%), 284 (1.8%), and 179 (1.1%) had Lung-RADS scores of 1 or 2, 3, 4A, 4B, and 4X, respectively. Among patients in the IPN cohort, 9204 (37.0%) had a baseline nodule diameter of less than 6 mm, 12 872 (51.8%) had a nodule of 6 to 15 mm, 1570 (6.3%) had a nodule of greater than 15 to 20 mm, and 1212 (4.9%) had a nodule of greater than 20 to 30 mm. The cumulative LCDR at 36 months was 3.8% (95% CI, 3.4%-4.1%) and 4.3% (95% CI, 4.1%-4.6%), with a median follow-up of 546 days (IQR, 237-996 days) and 647 days (IQR, 248-1279 days), in the LCS and IPN cohorts, respectively. With Lung-RADS 1 to 2 as the reference, AHRs were 3.38 (95% CI, 2.48-4.62), 7.41 (95% CI, 5.49-49.10), 25.46 (95% CI, 19.36-33.47), and 107.22 (95% CI, 82.76-138.19) for Lung-RADS 3, 4A, 4B, and 4X, respectively, and 0.59 (95% CI, 0.44-0.79), 2.66 (95% CI, 2.23-3.18), 9.93 (95% CI, 8.06-12.22), and 15.65 (95% CI, 12.67-19.32) for nodules less than 6 mm, 6 to 15 mm, greater than 15 to 20 mm, and greater than 20 to 30 mm in the IPN cohort. Five-year overall survival was 58% (95% CI, 52%-65%) and 46% (95% CI, 43%-50%) in the LCS vs IPN cohorts.

CONCLUSIONS AND RELEVANCE: In this cohort study of LCS and IPN program patients, approximately 4% were diagnosed with lung cancer over less than half the duration of the NLST cohort, suggesting a greater population-level LCDR through these screening programs than estimated by clinical trial data.

PMID:41973426 | DOI:10.1001/jamanetworkopen.2026.3171